How to avoid suboptimal management of cervical carcinoma by simple hysterectomy

Objective: To determine the reasons leading to atl inappropriate simple hysterectomy in the presence of carcinoma of the cervix and to evaluate factors related to survival. Methods: All preoperative information was abstracted from 63 cervical cancer patients cleared by simple hysterectomy from 1980-1993. Cervical cancer screening history as well as the indication for hysterectomy were analyzed. The 5-year survival was calculated and correlated with the tumour histological subtype and presumed stage of disease. Results: The most common preoperative symptom was abnormal uterine bleeding (73%). The absence of preoperative cytology, an inadequately evaluated abnormal Pap smear and the failure to differentiate from endometrial carcinoma were the main causes leading to an inappropriate simple hysterectomy. The cumulative 5-year survival was 63.5% and was correlated with the presumed stage of disease and the histological subtype. Conclusion: Only with close adherence to the cervical cancer screening-guidelines and appropriate evaluation of presenting symptoms can we avoid inappropriate management of cervical carcinoma with simple hysterectomy.